Update on HERC COVID-19 research

HERC project team: Paolo Candio, Phillip Clarke, Ana Gibertoni Cruz, Koen Pouwels, Laurence Roope, Mara Violato

HERC researchers have continued to contribute to the growing evidence base on COVID-19 since our last issue. In August, Laurence Roope and Philip Clarke published a new article in The Conversation explaining why and how we need to find out which incentives work related to COVID vaccine rollouts. 
 
In early September, HERC hosted a virtual symposium that explored effective ways to promote vaccine uptake and ensure public support for the effort and resources required to vaccinate the world. The symposium brought together perspectives of immunologists, epidemiologists, psychologists, economists and political scientists. Videos of the presentations from his event are now available here.
 
In late September, several HERC researchers contributed to a new publication that reported the results of a survey of 15,536 adults in 13 countries that considered COVID vaccine allocation priorities. A key finding was that, according to the global public, health workers and those at high risk should be prioritised, as well as a broad range of key workers and those with lower incomes. You can read more about this work here.
 
In October Laurence Roope contributed to an article in The New Statesman exploring the economics of drug discovery and the option value of research in the context of COVID-19. 
 
Finally, Koen Pouwels has contributed to several publications and preprints since our last newsletter. These have considered the effect of the Delta variant on viral burden and vaccine effectiveness, the impact of SARS-CoV-2 vaccination on variant transmission, the symptoms and SARS-CoV-2 positivity in the general population in the UK, and monitoring populations at increased risk for SARS-CoV-2 infection in the community. 

Patient-level models of severe mental illness: A systematic review

HERC project team: James Altunkaya, Jung-Seok Lee, Apostolos Tsiachristas, José Leal

Patient-level simulation models are valuable in severe mental illness, as they best capture the relationship between each patient’s complex disease course and their predicted health outcomes. These models are used to extrapolate outcomes from clinical trials, and evaluate the cost-effectiveness of new treatments. In a recent paper in The British Journal of Psychiatry, we found many current models were inadequate to inform the long-term value of interventions for severe mental illness, with deficiencies in model structure and parameterisation. We provide recommendations to support the development of future economic models in this area. You can read our paper here.

New evidence on the relationship between body mass index and health-related quality of life

HERC project team: John Buckell, Philip Clarke

The relationship between body mass index (BMI) and health-related quality of life (HRQoL) critically affects regulatory approval of interventions for weight loss, but evidence of the association is inconsistent. We collected data from multiple randomized controlled trials and combined it to generate a more robust estimate of this relationship. We found that, as expected, higher BMI correlates with lower HRQoL, though importantly HRQoL gains from weight loss were greater for those with more severe obesity. We suggest that commissioners should use these estimates for future decision making. You can read our paper here.

How do distressing aspects of illness influence public preferences for funding decisions?

HERC project team: Liz Morrell, James Buchanan, Sarah Wordsworth

Certain attributes of illness are identified as particularly distressing, but may not be accounted for explicitly in funding decisions. We used a discrete choice experiment among the UK public to quantify the influence of such attributes on the value of alleviating illness. Our results suggest a preference for prioritising conditions where there is unmet need, but not for other aspects of illness such as shortened life expectancy. These findings do not align with the characteristics prioritised in current UK policy. You can read our paper here.

What factors affect public acceptance of delayed antibiotic prescription?

HERC project team: Liz Morrell, James Buchanan, Laurence Roope, Koen Pouwels, Sarah Wordsworth

Delayed prescription is an effective tool for reducing antibiotic consumption in primary care. In a stated preference study reported in PLOS Medicine, we explored factors affecting public acceptance of delayed prescription for respiratory infections. Symptoms and duration of illness were the most important factors; findings for parents consulting for a sick child were similar. Some subgroups – including women, and people who are knowledgeable about antibiotics – were more amenable to delayed prescription. We recommended patient education about the causes of sore throats, and the expected duration of respiratory illnesses. 

Value of monitoring kidney function in UK primary care

HERC project team: Boby Mihaylova, Iryna Schlackow, Claire Simons

People with chronic kidney disease are at increased risk of heart attacks and strokes. Kidney function monitoring can help identify earlier kidney disease and its progression and target treatments to reduce cardiovascular risk. In a new HERC study, we combined estimates of the accuracy of the tests with subsequent treatment options. We found that kidney function monitoring every 3-4 years may be cost-effective for people with mildly reduced kidney function; it is, however, unlikely beneficial for people with kidney disease who are already recommended these treatments.

Junwen Zhou

Since joining HERC in October 2020, I have been working on economic modelling in cardiovascular disease using individual participant data from large clinical trials and observational studies. I am currently using data from the UK biobank to develop cost models to support health economic evaluations in cardiovascular disease. I have also been involved in teaching across the university as a tutor or lecturer. Prior to my current position, I worked in the private sector, developing economic models for HTA submissions. I am interested in using different techniques for modelling in health economic evaluation, such as microsimulation and discrete event simulation. You can read more about my work here.

Pamela Gongora

I joined HERC in October 2020 as a DPhil student to examine the suitability of multi-criteria decision analysis (MCDA) to support the commissioning of new models of care in England, under the supervision of Apostolos Tsiachristas, Rafael Perera, and Ray Fitzpatrick. So far I have analysed the commissioning context via interviews with key stakeholders and am conducting a systematic literature review on the application of MCDA in different healthcare decision contexts. To elicit stakeholders’ preferences for the MCDA I will conduct a discrete choice experiment to inform the development of a MCDA-based decision tool to help commissioners to assess new models of care. This project is part of the NIHR Oxford and Thames Valley Applied Research Collaboration (OTV ARC), which you can read more about here.

Aislinn Cook, who will be investigating how to use antibiotic resistance, prescribing, consumption and outcome data to improve national and local antibiotic prescribing guidance, under the supervision of Koen Pouwels. Aislinn holds a BS and BA in Biology and Community Health from Tufts University as well as a MSc in Control of Infectious Diseases from the London School of Hygiene and Tropical Medicine.  

Wadzanayi Muchenje, who joins HERC as a part-time DPhil student to study the cost of non-communicable disease management for health systems in Sub-Saharan Africa. Wadzanayi holds a BA in International Affairs from The George Washington University as well as a Masters in Public Health from Columbia University.

Ines Rombach

In October we waved goodbye to Ines Rombach. For many years, as a DPhil student and then as a Senior Researcher, Ines has been a great colleague to work with and a real asset to the HERC team. Efficient, focused on and dedicated to her work, Ines has faced all tasks with an outgoing, happy, can-do personality. We wish her every success and happiness with her new employer and hope to continue collaborating with her in the future as further exciting research opportunities emerge.